Comparing the predictive ability of portoatrial and portocaval gradient after transjugular intrahepatic portosystemic shunt creation for variceal rebleeding

• Published in: Journal of gastroenterology 2023-05, Vol.58 (5), p.494-502
• Main Authors: Ma, Li, Liu, Yaozu, Yan, Zhiping, Zhang, Wen, Zhang, Zihan, Yang, Minjie, Yu, Jiaze, Zhou, Xin, Chen, Shiyao, Wang, Jian, Ma, Jingqin, Luo, Jianjun
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Surgery; Biliary Tract; Bleeding; Catheters; Colorectal Surgery; Comparative analysis; Esophageal and Gastric Varices - etiology; Esophageal and Gastric Varices - surgery; Gastroenterology; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - surgery; Hepatology; Hospitals; Humans; Liver cirrhosis; Liver Cirrhosis - complications; Liver diseases; Local anesthesia; Medicine; Medicine & Public Health; Original Article―Liver; Pancreas; Patients; Portal vein; Portal Vein - surgery; Portasystemic Shunt, Transjugular Intrahepatic - adverse effects; Retrospective Studies; Statistical analysis; Stents; Surgical Oncology; Treatment Outcome
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-023-01977-w

Background Measuring the portal pressure gradient from the portal vein (PV) to the inferior vena cava (IVC) or to the right atrium (RA) remains controversial. The aim of our study was to compare the predictive ability of portoatrial gradient (PAG) and portocaval gradient (PCG) for variceal rebleeding. Methods The data of 285 cirrhotic patients with variceal bleeding undergoing elective transjugular intrahepatic portosystemic shunt (TIPS) in our hospital were analyzed retrospectively. The variceal rebleeding rates were compared between groups categorized by established or modified thresholds. The median follow-up time was 30.0 months. Results After TIPS, PAG was equal to ( n  = 115) or more than ( n  = 170) PCG. The pressure of IVC was defined as an independent predictor for a PAG-PCG difference of ≥ 2 mmHg ( p